Improving communication with primary care to ensure patient safety post-hospital discharge

Shivji, Faiz; Ramoutar, Darryl; Bailey, Chris; Hunter, J. B.

doi:10.12968/hmed.2015.76.1.46

Cited by 18 publications

(23 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was also found that GPs had little understanding of critical illness. Educational input that is commenced during initial training, and which is sustained through continuing professional development,12 , 32 is required to optimise this area of practice for all healthcare professionals.…”

Section: Discussionmentioning

confidence: 99%

Intensive care discharge summaries for general practice staff: a focus group study

2016

View full text Add to dashboard Cite

BackgroundUnderstanding how patients and relatives can be supported after hospital discharge is a UK research priority. Intensive Care Unit (ICU) discharge summaries are a simple way of providing GPs with the information they require to coordinate ongoing care, but little evidence is available to guide best practice.AimThis study aimed at better understanding the information needs of GP staff (GPs and practice nurses) supporting former patients of ICUs and their families following discharge from hospital, and identifying the barriers/facilitators associated with ICU–primary care information transfer.Design and settingThis was a qualitative exploratory study of practices and participants throughout the UK.MethodAudiotaped focus group discussions, complemented by small-group/individual interviews, were conducted with 15 former patients of ICUs, four relatives, and 20 GP staff between June and September 2015. Demographic data were captured by questionnaire and qualitative data were thematically analysed.ResultsFindings suggest variability in discharge information experiences and blurred lines of responsibility between hospital and GP staff, and patients/relatives. Continuity of care was affected by delayed or poor communication from the hospital; GPs’ limited contact with patients from critical care; and a lack of knowledge of the effects of critical illness or resources available to ameliorate these difficulties. Time pressures and information technology were, respectively, the most commonly mentioned barrier and facilitator.ConclusionEffective rehabilitation after a critical illness requires a coordinated and comprehensive approach, incorporating the provision of well-completed, timely, and relevant ICU–primary care discharge information. Health professionals need an improved understanding of critical illness, and patients and families must be included in all aspects of the information-sharing process.

show abstract

Section: Discussionmentioning

confidence: 99%

Intensive care discharge summaries for general practice staff: a focus group study

2016

View full text Add to dashboard Cite

show abstract

“…Many strategies to improve the quality of medication information in discharge summaries have been trialed, including guidelines, performance indicators, physician education and discharge summary templates with specific sections for medication information [3,8,15]. However, poor quality of discharge medication information persists [1,4,8,16].…”

Section: Introductionmentioning

confidence: 99%

Pharmacist–Physician Collaboration to Improve the Accuracy of Medication Information in Electronic Medical Discharge Summaries: Effectiveness and Sustainability

et al. 2019

View full text Add to dashboard Cite

Inaccurate or missing medication information in medical discharge summaries is a widespread and intractable problem. This study evaluated the effectiveness and sustainability of an intervention in which ward-based hospital pharmacists reviewed, contributed and verified medication information in electronic discharge summaries (EDSs) in collaboration with physicians. Retrospective audits of randomly selected EDSs were conducted on seven wards at a major public hospital before and after implementation of the intervention and repeated two years later on four wards where the intervention was incorporated into usual pharmacist care. EDSs for 265 patients (prescribed a median of nine discharge medications) were assessed across the three time points. Pharmacists verified the EDSs for 47% patients in the first post-intervention audit and 68% patients in the second post-intervention audit. Following the intervention, the proportion of patients with one or more clinically significant discharge medication list discrepancy fell from 40/93 (43%) to 14/92 (15%), p < 0.001. The proportion of clinically significant medication changes stated in the EDSs increased from 222/417 (53%) to 296/366 (81%), p < 0.001, and the proportion both stated and explained increased from 206/417 (49%) to 245/366 (67%), p < 0.001. Significant improvements were still evident after two years. Pharmacists spent a median of 5 (range 2–16) minutes per patient contributing to EDSs. Logistics, timing and pharmacist workload were barriers to delivering the intervention. Additional staff resources is needed to enable pharmacists to consistently deliver this effective intervention.

show abstract

“…However, a good structure and layout does not replace the training in writing medical DS. A study by Shivji et al has demonstrated that educational sessions improved the quality of written DS 26. We suggest that a course in writing DS should be included as part of the curriculum in medical schools, as it is important for junior doctors to learn how to prepare a DS.…”

Section: Discussionmentioning

confidence: 82%

Attitudes of physicians towards target groups and content of the discharge summary: a cross-sectional analysis in Styria, Austria

Hoffmann¹,

Schwarz²,

Pregartner

et al. 2019

BMJ Open

View full text Add to dashboard Cite

ObjectivesThe discharge summary (DS) represents one of the most important instruments to ensure a safe patient discharge from the hospital. They sometimes have poor quality in content and often include medical jargon, which the patient and their relatives cannot easily understand. Therefore, many risks for patient safety exist. This study investigated the questions for whom the DS is and which contents are necessary to ensure a safe treatment.DesignCross-sectional analysis.SettingStyria, Austria.Participants3948 internal and external physicians were consulted.InterventionsAn online survey consisting of 24 questions was conducted. The survey was distributed to physicians working in the province of Styria, Austria, in 2018 over a period of 6 months.Main outcomes and measuresAttitudes of internal and external physicians in terms of target group, content and health literacy.ResultsIn total, 1060 physicians participated in the survey. The DS is considered as a communication tool among physicians (97.9%) and the patients are also indicated as addressees (73.5%). Furthermore, there is a high level of agreement that understandable information in the DS leads to fewer questions of the patients (67.9%).ConclusionIn conclusion, the DS is not only seen as a document for the further treating physician but is also relevant for the patient. Incorporating the patient into their treatment at all levels may possibly strengthen the individual health literacy of the patient and their caring relatives.

show abstract

Improving communication with primary care to ensure patient safety post-hospital discharge

Abstract: This study has demonstrated how simple, intensive educational sessions can lead to an improvement in discharge summaries and communication with primary care.

Cited by 18 publications

References 11 publications

Intensive care discharge summaries for general practice staff: a focus group study

Intensive care discharge summaries for general practice staff: a focus group study

Pharmacist–Physician Collaboration to Improve the Accuracy of Medication Information in Electronic Medical Discharge Summaries: Effectiveness and Sustainability

Attitudes of physicians towards target groups and content of the discharge summary: a cross-sectional analysis in Styria, Austria

Contact Info

Product

Resources

About